Anyone with PAI-1 gene 4G/4G?

I was recently diagnosed with 2 copies of the plasminogen activator inhibitor gene, 4G/4G. I've had 3 pregnancy losses: 2 at 12 weeks and 1 at 8 weeks. I understand the PAI-1 gene and its role in the clotting cascade and how it causes miscarriage and I am so grateful that I finally have the probable answer to my losses. My question to anyone who has been diagnosed with this is: What did your doctor do to treat it? I do not have MTHFR or Protein C or Protein S. Luckily for me it's just PAI-1. My doctor, who is a friend of mine and I do trust, is having me take a baby asprin daily now and throughout a hopeful next pregnancy. There is not alot of information online about this gene and its role in pregnancy loss or about the treatment but I did find some posts that said they taking Lovenox and one lady who took asprin and still lost a baby. I'm so scared to lose another pregnancy and am totally willing to take Lovenox if thats what it takes. Any insight intothis would be great!!

Comments (24)

Will you ask her if PAI-1 is the only thing they found? I know if you have Protein C or S along with it they def put you on Lovenox. I don't know I just want to take the Lovenox but I don't know if my doctor will agree......Thanks so much!!

I recently had genetic testing done....all clear there. The gentic doc also did our preliminary blood work and found that I am homozygous for MTFHR and had elavated levels for the antiphospholipid syndrome.

I just met with the hematologist to confirm the antiphospholipid diagnosis and he is doing additional tetsing. He gave me some literature to look over and specifically said to look at the PAI info....problem is that I live in Germany, the info is in German, and I don't speak German :( I have not been able to find much info on the web about it.

I will be on lovenox during my next pregnancy, so I know that doesn't help the original poster very much. sorry.

I have Pai1 4g4g as well. (I also have mild antithrombin III.) I took 81mg of aspirin daily and 40mg shot of Lovenox once daily as well. I was told (at the time...2 years ago) by my RE and hematologist that the pai1 alone wouldn't cause the miscarriages. (With that said, I'm not saying not to take the medicine because I did and would all over again!) Like I said, I took the medicine anyhow assuming if there was something else that wasn't discovered I'd be covered with the meds, even if somewhat empirical.Are they saying differently now in regards to the pai1 and miscarriage chances?

Through all my research, I found that Pai 1 was a little related with pcos. I asked to be tested for that even though, according to my ob and RE I was not a likely candidate (my periods are mostly regular, not too difficult getting pregnant, I'm not overweight, etc.) and my insulin levels were barely elevated (but elevated!), therefore I started with metformin as well. PAI 1, PCOS, healthy eggs all have to do with the endocrine system (directly and indirectly) so I wanted to do everything I could. I think all this really helped me carry a successful pregnancy.

Hi, I'm sorry for your three losses, I know what it is like. I also have the pai-1 4g thing. I also have mthfr homozygous and very mild pcos. It's interesting that Izzi wrote the correlation between pai and pcos. I just got a presciption for Metformin (i started it last week and then stopped because I was so tired from it.) Maybe I should start it again.

I have also had three miscarriages. The first two they did not have any idea what was wrong with me. By the third I was on folgard, baby aspirin, and during the pregnancy 40 ml lovenox 1x day. The perientologist said next time he would increase the lovenox and see if that did the trick.

I subsequently did some reading on my own and found pcos people have a very high miscarriage rate, taking the metformin can help reduce the mc rate for pcosers. I am slightly overweight and most of my test do not indicate pcos, however one test does. So you don't have to fit the stereotypical description of pcos in order to have it.

So you don't have to fit the stereotypical description of pcos in order to have it.

ITA and my doctors were reluctant to test for it because I didn't fit that description and I kinda had to insist on it. As we all know, no matter how supportive our team of doctors are, we still have to be our own advocate.

Liv, the metformin kicks my butt too. I just started it back (going to try for #2 soon) and I can't get up to the 3rd dosage, everytime I do I'm so nauseous and just feel like crap. So, I always go back to 2. Do you take it all at once or spread out 3x a day?I know I'll never know for sure, but I think this medicine made the difference for me. My RE says that as an average, one needs to be on it for about 3 months for it to do its job. Just wanted to throw that out there! Also, my first pregnancy that I was on lovenox (which was my 4th miscarriage overall) ended in a miscarriage too. I then started the regimine with metformin for a few months, and got pregnant with my keeper and continued the metformin until the second trimester, and aspirin, lovenox, calcium, prenatals throughout the pregnancy.

So I talked to my doctor and she basically said taking the Lovenox is up to me. My case isnt really clear cut since the last pregnancy was a very rare anomally that can possibly be associated with blood flow issues but they dont really know. I'd rather be safe than sorry so i'm going to take the Lovenox. Now however i'm wondering about the Metformin. I am overweight but do not have any other "typical' PCOS symptoms of PCOS however the last 3 ultrasounds i've had all the sonographers have asked me if I have PCOS because my ovaries have so many cysts. I didnt mention this to my doctor because I didnt think it was an issue but now reading your posts i'm concerned I should be on Metformin. LOL My Friend is going to think i'm nuts!!! I dont want to drive her crazy but I want to do as much as possible to not lose my next baby!!

last 3 ultrasounds i've had all the sonographers have asked me if I have PCOS because my ovaries have so many cysts.

You can find out with blood work. I'd definitely have the doctor look into this further for you, especially since you've been asked so many times with ultrasounds. Do more research on it for yourself and go from there too. Good luck.

I dont know if I have this or not but my doc put me on baby aspirin with this pg and so far so good we saw baby and hb thursday, but then honestly I had some spotting on friday and for right now just chalking it up to the transvaginal u/s but I really dont know for sure and probably wont until my next u/s if they do one.

I have PAI-1 4G/4G and had 2 miscarriages: 1 at 6 1/2 weeks and 1 at 9 1/2 weeks and an ectopic pregnancy. However, I am now 16 1/2 weeks pregnant! Feeling much more confident now! I only take a vitamin and an 81 mg aspirin each night. I had two well-regarded high risk OB doctors tell me Lovenox was not necessary. I'm sure I could have taken it had I pushed the issue.